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目的 探讨屏气试验 (BHT)作为指导老年高血压合并腔隙性脑梗死患者 (简称实验组 )降压治疗辅助检查的应用价值。方法 实验组在不同血压水平下分别进行屏气试验 ,利用 TCD测定其脑血流动力学参数。结果 (1 )与正常对照组比较 ,实验组大脑中动脉平均血流速度 (Vm)明显降低 (P<0 .0 1 ) ;而降压治疗前、后 Vm无统计学差异 (P>0 .0 5 ) ;(2 )闭气指数 (BHI)及 Vm上升率检测 :实验组降压治疗前较正常对照组明显下降 (P<0 .0 1 ) ;平均动脉压 (MAP)下降约 1 2 .7%时 ,较降压治疗前有所改善 ,但无统计学差异 (P>0 .0 5 ) ;MAP下降约 2 2 .6 %时 ,较治疗前显著提高 (P<0 .0 1 ) ;(3)在 1 2 .7%和 2 2 .6 %的降压幅度分别有 6 %和 1 9%患者出现 BHI及 Vm上升率下降 ,但两者发生率无统计学差异 (P>0 .0 5 )。结论 实验组存在明显的脑血流灌注下降 ,脑血管反应性降低 ;持续较低的降压治疗总体是有益的 ,但需注意个体化原则 ;屏气试验可作为指导降压治疗的辅助检查之一
Objective To investigate the value of breath holding test (BHT) as a guide for antihypertensive therapy in senile patients with hypertension and lacunar infarction (abbreviated as experimental group). Methods The experimental group were breath-hold test at different blood pressure levels, and their hemodynamic parameters were measured by TCD. Results (1) Compared with the normal control group, the mean arterial blood flow velocity (Vm) in the experimental group was significantly decreased (P <0.01), while there was no significant difference in Vm between the two groups before and after antihypertensive treatment (P> 0.05). 0.05). (2) BHI and Vm rise rate: The experimental group decreased significantly (P <0.01) before the treatment and the mean arterial pressure (MAP) decreased about 12 before treatment. (P <0.05), while MAP decreased by 2.2.6% compared with that before treatment (P <0.01) ; (3) The rate of increase of BHI and Vm decreased in 6% and 19% of patients with decompression rate of 12.7% and 22.6% respectively, but there was no significant difference between the two .0 5). Conclusions The experimental group showed decreased cerebral blood flow perfusion and decreased cerebrovascular reactivity. Continuous lower antihypertensive treatment was beneficial overall, but individual principle should be paid attention to. The breath-hold test can be used as one of the auxiliary tests to guide the antihypertensive treatment